Healthcare Provider Details

I. General information

NPI: 1962069492
Provider Name (Legal Business Name): AMNOP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 MOUNT PLEASANT AVE STE 210
WEST ORANGE NJ
07052-2751
US

IV. Provider business mailing address

73 GLEN AVE P O BOX 43
GLEN ROCK NJ
07452
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMUL PATEL
Title or Position: OWNER
Credential: MD
Phone: 908-653-9399